Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Breastfeeding – The Best Start

Breastfeeding provides ideal nutrition for infants. The World Health Organization (WHO) states that children should receive only breast-milk for the first six months of life. Additional foods are recommended only after this period of time, with breastfeeding continuing for up to two years and beyond.
In order to promote and support breastfeeding, the WHO and UNICEF (United Nations Children’s Fund) have described the “Ten Steps to Successful Breastfeeding”. These steps assist hospitals and maternity centres to help you breastfeed your baby. These ten steps include:

Having a written breastfeeding policy that is reviewed on a regular basis with all healthcare staff

Training all staff to use this policy

Giving all pregnant women information about the benefits and management of breastfeeding

Helping mothers to start breastfeeding within a half-hour of birth

Showing mothers how to breastfeed and maintain a supply of breast-milk, even if they are away from their baby

Not giving newborn babies any food or drink other than breast-milk, unless needed for a medical reason

Letting mothers and babies to remain together 24 hours per day (rooming-in)

Encouraging breastfeeding on demand

Giving no pacifiers to breastfeeding babies

Helping to start breastfeeding support groups, and helping mothers to access them on discharge from hospital or clinic

Factors that influence your choice to breastfeed your baby:
Studies have shown that women make their decisions about whether or
not to breastfeed their baby either before or during pregnancy. Factors
that influence your decision include:

your intentions about feeding your baby – Do you want to breastfeed?

your commitment to breastfeeding – How long would you like to breastfeed?

your attitude towards breastfeeding – How do you feel about breastfeeding?

your ethnic background – How does your family support breastfeeding?

your social support system – Is your community “breastfeeding-friendly”?

exposure to other women who have breastfed their babies – Do you know women who have breastfed their babies?

How nurses can support your choice to breastfeed your baby:
Nurses and other healthcare providers will work with you to support your breastfeeding experience in a number of ways. Before your baby is born, nurses or other healthcare providers will ask about:

your decision regarding breastfeeding

your support system, including family, friends and other healthcare providers

attitudes among the people in your support system about breastfeeding

previous and current health factors

After the baby is born, nurses or other healthcare providers will review the following:

your delivery, and what medications you may have received during labour and delivery

your baby’s physical health

your baby’s position at the breast, how the baby “latches”, and signs that your baby is getting milk

how you and your baby respond to each other, and your understanding of your baby’s feeding patterns

how you feel about your hospital breastfeeding experience and your confidence in breastfeeding at home

Nurses and other healthcare providers may also support breastfeeding by:

providing education so that you can make informed decisions about feeding your baby

working with you to increase your knowledge and skills in breastfeeding

making sure you are aware of your rights to breastfeed your baby

encouraging a supportive breastfeeding network

working in your community to make “breastfeeding-friendly” places available

providing you with details about resources in your community for additional information or help with breastfeeding